ALZ Association talks younger-onset Alzheimer's

More than 5 million Americans are living with Alzheimer’s disease. It is the sixth leading cause of death in the U.S. One in three seniors will die with some form of dementia, with Alzheimer’s making up 60-80 percent of all dementia cases. Though there isn’t a cure, early detection of the disease can help extend and increase the patient’s quality of life. Healthy New Albany Magazine sat down with Tricia Bingham, director of programs and services at the Alzheimer’s Association, Central Ohio Chapter to discuss younger-onset Alzheimer’s and the importance of early detection.

HNA: What’s the difference between Alzheimer’s disease and dementia?

Tricia Bingham: Dementia is a condition in which a person has significant difficulty with daily functioning because of problems with thinking and memory. Dementia is not a single disease; it’s an overall term, like heart disease, that covers a wide range of specific medical conditions, including Alzheimer’s disease (AD).

AD is the most common form of dementia and accounts for 60-80 percent of all dementia cases. Some other forms of dementia include vascular dementia, Parkinson’s disease dementia, Lewy body dementia, mixed dementia and Huntington’s disease.

HNA: What puts someone at risk for younger-onset Alzheimer’s disease?

TB: Family history increases one’s risk factors. Those who have had a parent or sibling with the disease are at a greater risk of developing AD, and the risk increases if more than one family member has the illness. The vast majority of individuals with AD have late-onset disease, occurring at age 65 or later. Experts believe AD is caused by a wide range of risk factors. These include, but are not limited to, advanced age, family history of AD, genetics and lifestyle factors such as diet, exercise and smoking.

HNA: What’s the difference between early stage and younger-onset? At what age is it considered younger-onset Alzheimer’s?

TB: AD typically progresses slowly in three general stages: early, middle and late. When someone is in early stages of the disease they are able to still function independently. He or she may still drive, work or be a part of social activities, although the person may feel as if he or she is having memory lapses, such as forgetting familiar words or the location of everyday objects. Younger-onset AD, also referred to as early-onset, is when symptoms of dementia occur before the age of 65. Someone with younger-onset Alzheimer’s will go through all three stages of the disease, just as someone who is diagnosed at 65 or older.

Younger-onset AD, also referred to as early-onset, is when symptoms of dementia occur before the age of 65. Someone with younger-onset Alzheimer’s will go through all three stages of the disease, just as someone who is diagnosed at 65 or older.

HNA: What are the stages of Alzheimer’s disease?

TB: AD typically progresses slowly in three general stages: early, middle and late, sometimes referred to as mild, moderate and severe in a medical context. Since AD affects people in different ways, each person may experience symptoms – or progress through the stages – differently.

On average, people in early stages can still maintain an independent lifestyle, but will notice difficulties with concentration and memory problems such as coming up with the right word or name. They also face challenges performing tasks in social or work settings and forget material that was just read.

Middle-stage Alzheimer’s is typically the longest stage and can last for many years. Also as the disease progresses, individuals may experience changes in personality and behavior, such as anxiety, suspicion or agitation, as well as delusions or hallucinations. Alzheimer’s will require greater levels of care and instruction as the disease progresses.

For instance, needing to help the individual with choosing proper clothing for the season or occasion and eventually assisting with dressing, bathing, and eating.

The late-stage is the final stage of the disease and individuals lose the ability to respond to their environment, carry on a conversation and eventually, control movement. On average a person with Alzheimer’s lives four to eight years after diagnosis but can live up to 20 years, depending on other factors.

HNA: If someone has younger-onset Alzheimer’s, does that mean they are likely in the early stages of the disease?

TB: Not necessarily. Someone with younger-onset will progress through all three stages of the disease before turning 65 and therefore could be in early, middle or late stages of younger-onset AD.

HNA: How much difference can be observed in patients who treat the disease at an earlier stage?

TB: Although there is no cure or way to prevent or slow the progression of the disease, early detection is key to improving quality of life. Current medications for dementia can benefit those in the earliest stages. By treating the disease path earlier versus later one can help to alleviate some disease symptoms for a period of time.

An early diagnosis allows individuals to take advantage of available treatments and participate in clinical research study trials. Additionally, an early diagnosis allows time to plan for the future, including putting legal, financial and care plans in place allowing for the individual with dementia to be involved and proactive in care decisions with the care partner.

On average, people in early stages can still maintain an independent lifestyle, but will notice difficulties with concentration and memory problems such as coming up with the right word or name. They also face challenges performing tasks in social or work settings and forget material that was just read.

HNA: What are the genetic risk factors for developing Alzheimer’s?

TB: Research has shown that those who have a parent or sibling with Alzheimer’s are more likely to develop the disease than individuals who do not. The risk increases if more than one family member has the illness. Two categories of genes influence whether a person develops the disease: risk genes and deterministic genes. Risk genes increase the likelihood of developing a disease but do not guarantee it will happen. Deterministic genes directly cause a disease, guaranteeing that anyone who inherits one will develop a disorder.

HNA: How does one diagnose Alzheimer’s?

TB: There is not a single test to prove a person has Alzheimer’s. A comprehensive medical evaluation is key which involves a medical exam and possibly cognitive tests, a neurological exam and/or brain imaging. The workup is designed to evaluate the overall health and identify any conditions that could affect how well the mind is working. When other conditions are ruled out, the doctor can then determine if it is Alzheimer’s or another dementia.

If you suspect you or someone you care about is experiencing Alzheimer’s disease or a related dementia or you just have questions please visit our website at www.alz.org or please call 800-272-3900 (24/7 helpline). We are here to help guide, offer assistance and support.

HNA: What can be done to reduce one’s risk of developing Alzheimer’s or other forms of dementia?

TB: While there is still no known way to prevent AD, emerging research suggests that the steps people take to maintain heart health including eating a healthy diet and exercise, as well as healthy sleep and lowering stress levels, may also reduce the risk of cognitive decline.

HNA: Are there behaviors or lifestyle choices that decrease one’s risk?

About the Expert

Tricia Bingham, MA, LSW, has been the director of programs and services at the Alzheimer’s Association, Central Ohio Chapter for the past three years. She has provided leadership and direction for the development, implementation and evaluation of Alzheimer’s Association programs and services in the Area Chapter territory (14 central Ohio counties). Bingham has her Master of Arts in gerontology and is a licensed social worker.

Jenny Wise is an assistant editor. Feedback welcome at adeperro@cityscenemediagroup.com